The ‘Hands-Only’ Approach to CPR

After all these years of chanting “ABC” under our breaths when confronted with a collapsed patient, healthcare providers need to change their chant to “CAB.” The American Heart Association has issued new guidelines for emergency resuscitation. The new standards direct rescuers to use the mnemonic CAB to remind them to address the situation in the following order:

C: Compressions

A: Airway

B: Breathing

But even more importantly, when a lay person in an out-of-hospital situation (for example in a home or public place) encounters an adult who has collapsed, the AHA is recommending “Hands-only CPR.” No rescue breaths are given at all — instead, the bystander/rescuer is instructed to call 911 (or send someone else at the scene to call 911) and to immediately begin chest compressions.

“Compressions” refers to the act of pumping on the chest of someone whose heart has stopped. By pushing correctly in the center of the chest, the heart can continue pumping blood throughout the body, ensuring that vital tissues (such as the brain, the heart muscle, the kidneys, etc.) continue to receive oxygen. The compressions should be performed at a rate of about 100 per minute, and to a chest depth of about 2 inches. Compressions should be maintained until trained help arrives.

One hundred compressions per minute is a pretty good clip — when I had training recently, the instructor suggested pumping to the rhythm of the Bee Gees’ song “Staying Alive.” (He also pointed out that the song “Another One Bites the Dust” provided the same pace, but suggested this might be a less palatable song to be humming during a rescue.)

Research has shown that hands-only CPR saved lives 22 percent more than the traditional method of alternating breathing and compressions. Estimates suggest that training the public to use hands-only CPR could save 3,000 people yearly in the United States.

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ABOUT THE AUTHOR

Rosalyn Carson-DeWitt, MD

Rosalyn Carson-DeWitt, MD integrates an undergraduate English degree from Kalamazoo College and a medical degree from Michigan State University in her work as a medical writer, editor, and consultant. She...read more